Making pharmacy connections in the frozen north
What Mariam Elsoukkary learned about flexibility, cultural sensitivity and resilience as a pharmacy assistant in Nunavut.
Mariam Elsoukkary (she/her), a third-year Pharmacy student, shares her experience working in a pharmacy in Iqaluit, Nunavut. She discusses adapting to a slower pace, living with limited resources and learning to be more culturally sensitive and flexible in her approach to patient care. Despite these challenges, Mariam found the experience rewarding and encourages other students to consider working in northern communities.
Mariam's co-op journey
Work term one: In her first work term, Mariam was the student of professional affairs for the Canadian Pharmacist Association. She created resources for pharmacists, worked on advocacy projects and sat in on board meetings with Health Canada and other stakeholders. Mariam also got to create a resource for pharmacists on how to support their colleagues and patients during Ramadan.
Work term two: Mariam then worked at WRHN @ Chicopee (formerly Grand River Hospital, Freeport Campus) as a pharmacy student, helping in several different units of the hospital. She would see patients and gather information for their best possible medication history as well as assist with tracking medications for patients during their stay.
Work term three: For her third and final work term, Mariam worked for Northmart Pharmacy in Iqaluit, Nunavut as a pharmacy assistant. Mariam took on a number of different roles and tasks including counselling patients about new medications and data entry for prescriptions. This role also reconnected her with her preceptor, Chris Voss (PharmD ’19), who posted the job on WaterlooWorks.
Q&A with Mariam
What is it like working in Iqaluit, Nunavut compared to Ontario?
“It's been interesting to see the differences between Ontario and Nunavut. In Ontario we have minor ailments, so pharmacists can prescribe medication for a lot of different conditions. We have a structured assessment that we go through in Ontario. Up north, we don't have that yet, but they're looking to expand the scope and hopefully it'll even be better than Ontario.”
“There are a lot of hurdles we have to overcome because the pharmacy is under renovation. We're working in the construction zone right now, which is kind of crazy. We don't have a counseling room, so a lot of these interactions I'm having with patients are just out in the aisles and that's not always, in my opinion, the best for patients. Right now, Public Health only gives vaccines, which is interesting because I just got my injection certification and was giving vaccines before I came up here.”
“Everything is a little bit slower here. When I first interviewed for this position, my preceptor, who works at this pharmacy, was telling me that they’re switching to paperless and then I came up here and they’re still hybrid. Even with new regulations they want to change, it likely will take some time to implement.”
“You can see your impact directly on the patients because it's a much smaller community. We're one of two pharmacies here, so it gets super busy. We actually had another pharmacy that was open for the same company that recently closed because we don't have enough staff.”
“I also never had to worry about the logistics of sending medications by plane before. But here we have to think about if I’m sending something that needs to be refrigerated. I need to figure out the right timeline to do that. Do we have a cooler? Is it going to stay in a refrigerated area? Is it going to be out too long before it ships out?”
How has your perspective on pharmacy evolved throughout your co-op experiences?
“It's interesting working as a pharmacy student because when you're in school, you're learning how to do all these things by the book. Then sometimes when you come to work, everybody's doing things differently.”
“One of the things I noticed up here, for example, is we have a very structured way of counseling in school. I usually follow certain questions that I always ask patients. But because here there's a history of, unfortunately, abuse towards Indigenous communities, not everyone here feels comfortable with that type of questioning.”
“I've learned to try to condense the way that I ask questions and explain more why I'm doing it. I'm trying to find out what's the best thing that we can do to support the patient.”
“I've become a lot more culturally sensitive to how we approach health care. But at the same time, I try to make sure that I'm still asking the most important questions that I need to know to help the patients.”
“One of the things I’ve been super supportive of is expanded scope. That’s why I want to get my story out there. I want to encourage more people to take the leap and work in these northern communities. There are a lot of jobs up here, they need support and it’s a unique experience that you learn a lot from.”
How did working with interdisciplinary teams shape your understanding of collaborative care?
“One of the things that I really enjoy about collaborative care is that everybody has their own perspective to bring to the table, which I find really helpful right now. At the community pharmacy, one of the nurses at the clinic decided that she wanted to work with us part time and I have learned so much from her.”
“Working with other assistants and technicians is always great and crucial in community pharmacy and there's a lot of things that they know that I don't working in this community. They're really helping me with a lot of technical aspects of data entry, navigating Non-Insured Health Benefits prior approvals and more.”
“I had a great conversation with a nurse practitioner about patients that come in with refugee status during a concert. They have certain documentation that you can use for coverage. It's something that I didn't know about, she taught me how we enter that in the pharmacy to get their medications covered.”
“That's something that I didn't expect from community pharmacy, because normally when I think of interprofessional collaboration, I'm always thinking about the hospital.”
“But to be honest, I think here I've had more real collaboration because we are having those genuine conversations that has supported my learning.”
What has been the most memorable moment from your co-op terms?
“For my first co-op, it was a resource that I got to work on for Ramadan. I think that was definitely one of my most memorable experiences, as well as getting to know the chief of pharmacy. We've sort of become good friends after working with her closely, which was really cool. She was one of the first people that I told about coming up to Nunavut.”
“For my second co-op, I think the shadowing experience was probably the highlight because I got to see how different it is to work in each department.”
“Then for my last co-op, there's so many things that I can talk about. I can't pinpoint one thing. I've been trying to get out more. I've gone shooting. I've gone fishing. I drove an ATV. I went dog sledding in May.”
“I went to a music festival called Alianait. It was my first time going there and it was all in Inuktitut. That's the main language spoken here and they had a couple of cool bands that came to perform.”
“They had a craft fair, so they sold really cool earrings. I bought a lot of stuff, even though I brought way too many things here. I now have seal skin earrings, arctic fox earrings and a lot of animal fur. I don't know how I'm going to travel with all of this stuff when I come back because I definitely overpacked. But it's been really cool to see and buy those kinds of things.”
What’s next for you?
“I don't know. I have to finish my degree and go on rotations. After I graduate, I’m planning to work in a rural community in Ontario for a couple of years. I'm keeping my options open. There's a lot of things that I'm interested in and I want to dabble in it as much as I can.”